Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 001893 | KY |
N | 225100000X | Physical Therapist | 070-007875 | IL |
N | 2251S0007X | Physical Therapist - Sports | 001893 | KY |
N | 2251X0800X | Physical Therapist - Orthopedic | 001893 | KY |
NPI | 1376540625 |
---|---|
Provider Name | Mr. Robert William Caturano JR. |
First Address | Paducah, KY 42003 |
Second Address | Paducah, KY 42003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2005 |
Last Update Date | 11/09/2012 |